Enrollment and retention of female sex workers in HIV care in health facilities in Mbarara city
Date
2023Author
Arinaitwe, Bridget
Ariho, Philbert
Naturinda, Christine Hilda
Byoleko, Brian
Base, Anitah
Atwijukiire, Humphrey
Matavu, Hariat
Kabami, Jane
Obua, Celestine
Wakida, Edith K.
Otwine, Anne
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Show full item recordAbstract
Background: Sex work is a global driver of the HIV epidemic, and the risk of
acquiring HIV is 13 times higher for female sex workers (FSWs) compared to the
general population. The enrollment and retention of FSWs in HIV care is a
challenge and has been a major contributing factor to increased new HIV infections.
Methods: We conducted a qualitative study among 30 FSWs and 21 healthcare
workers (HCWs) working in antiretroviral therapy (ART) clinics at the selected three
primary health facilities in Mbarara City, Southwestern Uganda. The study
participants were enrolled by both purposive and snowball sampling techniques.
We obtained informed consent from all the participants, and data were collected
using in-depth interviews and thematically analyzed.
Results: Three themes emerged as facilitators toward enrollment and retention of
FSWs into HIV care, namely, (1) good health living, (2) receptive HCWs and
availability of health services, and (3) community outreach services and peer
support. The barriers are summarized into four major themes: (1) stigma,
community discrimination, and beliefs; (2) social obstacles; (3) adverse effects of
ART; and (4) inadequate services at the health facilities.
Conclusion: FSWs are challenged by unsupportive environments and communities
where they live and work, which hinders their enrollment and retention in HIV care.
Creating awareness of the utilization of HIV care services and extending such services
to hotspot communities could enhance the response of HIV-positive FSWs to ART